Finding the Best Rehab for You (How-To Guide)

Drug addiction is a chronic disease that changes some structures in the brain through ongoing abuse of certain chemicals, like alcohol or opioids, due to compulsive behaviors around substances. Addiction treatment focuses on evidence-based practices to overcome these behaviors so the individual struggling with addiction can get physically, mentally, and emotionally healthy.

There are three basic steps to take when overcoming addiction: 

1. Medical detox to end physical dependence on the substance
2. Rehabilitation, which provides behavioral therapy in groups or individually or both, to change behaviors
3. An aftercare plan, to manage co-occurring conditions, cravings, and the potential emergence of compulsive behaviors again

While these three parts of treatment create a solid foundation for long-term recovery, the National Institute on Drug Abuse (NIDA) states in their Principles of Drug Addiction Treatment that no single approach to any of these steps will work for everyone. Each individual has different needs, and this is especially true when it comes to approaches to therapy in a rehabilitation program.

To get the best rehab for you or a loved one, you should understand how clinicians diagnose addiction, different levels of treatment and what they provide, and what sorts of questions you can ask of treatment programs before you sign up.

Physical Needs in Rehab

If you have concerns about how you take drugs or drink alcohol, you should visit a physician for a diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has 11 updated criteria that clinicians use to diagnose substance use disorders.

1. Consuming more of the substance than you intend to or for longer than you intend to
2. Trying to stop the abuse of the substance and being unable to stop
3. Spending a lot of time and money using drugs or drinking alcohol
4. Abusing the substance to the point of being unable to fulfill work, school, family, or personal obligations
5. Intense cravings for drugs or alcohol
6. Developing physical or mental problems from drug abuse but continuing to abuse the substance
7. Experiencing a negative impact on personal relationships from substance abuse but being unable to stop
8. Abusing the drug or alcohol in dangerous situations, such as intoxicated driving
9. Giving up hobbies or activities to abuse drugs or alcohol more often
10. Developing a tolerance to the substance, so you feel like you need to consume more to get the original effects
11. Experiencing withdrawal symptoms when you try to quit or cannot abuse the substance

The American Society of Addiction Medicine (ASAM) lists different levels of care on their continuum. The continuum offers different approaches to social, psychological, and medical care depending on what your needs are when you seek rehabilitation.

• Level 1: general outpatient treatment, attending group or individual therapy for nine hours a week or less
• Level 2: intensive outpatient treatment, with more than nine hours per week of therapy, or partial hospitalization, with short-term physical stabilization and eventually stepping down to outpatient rehabilitation
• Level 3: residential or inpatient treatment programs, which are important for people who are not able to avoid substances while living at home or whose home lives are too unstable to be safe
• Level 4: inpatient treatment that also provides intensive medical management to keep the person physically stable

There are other factors that may impact the treatment path you follow:

• Age
• Gender
• Whether you have children
• Specific drugs of abuse
• Medical history, including mental and physical health
• Overall cost of treatment at a particular program
• Insurance coverage
• Social support from friends and family

When you visit a physician for a diagnosis, they will consider your demographic factors, current financial and social support, and what level of care you need based on the severity of your addiction. Once you have this diagnosis, there are other things you should consider when looking for the best treatment program for you.

Questions to Ask Any Rehab Program

You may receive a specific recommendation, or list of recommendations, from your physician after you have been assessed for substance abuse. This is a great starting point and should reflect your specific physical and behavioral needs. Here are some questions you can ask to find the best rehab for you:

• What is the client-to-staff ratio?
• Is there a medical director on staff?
• What sorts of medical needs does the program handle?
• What are the licenses, state regulations, awards, and nonprofit certifications the program has? This will reflect all the standards the facility meets.
• If the program is inpatient, are licensed staff members available 24 hours a day?
• What sorts of programs are offered in treatment? Is it predominantly group therapy, or are there options for individual therapy, complementary medicine, art therapy, equine therapy, spiritual or religious practices, or other approaches?
• Is there a social worker or case manager who will oversee the treatment plan?
• Will a therapist help create an aftercare plan? Will there be follow-up care once the rehab program is complete?
• Does the rehab program take insurance, offer a sliding scale, have any free options, or offer payment plans?

If you are not the person seeking treatment, you can still ask these questions of a rehab program to understand how they may work for your loved one. You can then present these options to your loved one in a safe, calm environment when the person is sober and able to listen.

Where to Find the Best Rehab Options

When searching for treatment, it can also be important to find resources that are closest to you geographically, financially within reach, and that align with your needs and beliefs. Here are some resources to find treatment options:

• The Behavioral Health Treatment Services Locator through the Substance Abuse and Mental Health Services Administration (SAMHSA)
• The Membership Directory through ASAM
• Information for Patients and Families through the American Academy of Addiction Psychiatry (AAAP)
• The Association for Addiction Professionals (NAADAC)
• Treatment Navigator for alcohol use disorder (AUD) through the National Institute on Alcohol Abuse and Alcoholism (NIAAA)

We know that quitting is never easy, but together there is always hope.